Severe coronary artery disease was found in 340 (84%) of these 403 deaths, with plaque fissuring or thrombi in 189 or 151 cases, respectively.

Among the 229 sudden deaths for whom no immediate cause could be determined (31% of the total population), all had evidence of heart disease : 147 individuals had severe coronary artery disease, with plaque fissuring or thrombi found in 72 or 43, respectively.

The remaining cases with no immediate cause of death had evidence of a cardiomyopathy (61) or valvular disease (21).

We conclude that acute myocardial infarction accounts for the majority of cases of nontraumatic sudden death in our Emergency Department.

Altogether, 84% of these patients had severe coronary artery disease.

In approximately one-third of cases for whom no immediate cause of sudden death could be determined, all had evidence of heart disease, and about two-thirds had severe coronary artery disease.